Abstract

Assumptions followed during construction of B-mode and color flow images are that the pulse-echo transit time can be converted to reflector depth through uniform tissue models, echoes originate only from locations along the transmit-receive axes of pulse propagation, and first order correction schemes adequately account for acoustic wave attenuation and absorption. The latter allows the display brightness to encode tissue echogenicity. This course will challenge participants to identify imaging artifacts whose origins stem from the more complex and realistic propagating and scattering conditions common in clinical ultrasound. Speckle, a very common artifact but a clinically employed feature, originates from simultaneous echoes from diffuse scatterers and is a result of coherent detection of signals. One of the most bothersome artifacts are those due to reverberations especially that originating from superficial tissue interfaces. Methods to overcome these will be discussed. This presentation also will describe and illustrate speed of sound, refraction, enhancement, shadowing, mirroring, beam width, beam-forming, and slice thickness artifacts. All are useful examples of limitations introduced by acoustic waves propagating through complex tissue paths. New formats for physician board certification exams are demanding the inclusion of image-based examples of ultrasound physics. Instructors' knowledge of, and access to examples of ultrasound artifacts are important in this effort. The presentation will incorporate an audience response system to challenge participants in correct identification of some of these artifacts.